Provider Demographics
NPI:1255694451
Name:SUHAIL, MOHAMMAD FAIZUL (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD FAIZUL
Middle Name:
Last Name:SUHAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 JOHNSON AVE
Mailing Address - Street 2:APT# 6K
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3510
Mailing Address - Country:US
Mailing Address - Phone:609-424-8750
Mailing Address - Fax:
Practice Address - Street 1:130 W KINGSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3904
Practice Address - Country:US
Practice Address - Phone:718-584-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
RIMD15056207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program